Pharmacy Services

pharmacy searchableCenCal Health Pharmacy Services provides a comprehensive pharmacy benefit that includes formulary management, a robust pharmacy network, and quality customer service. Our pharmacy network spans both Santa Barbara and San Luis Obispo Counties providing our members with convenient pharmacy locations.

Pharmacy Benefit Manager

CenCal Health has contracted with MedImpact as its Pharmacy Benefit Manager (PBM) to assist in the administration of our pharmacy benefit.

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MedImpact provides: 

  • Claims processing
  • Pharmacy network management
  • Prior authorizations
  • Customer service
  • Drug utilization management services

CenCal Health Pharmacy Team shall oversee MedImpact’s administrative and daily operational role. To contact MedImpact, call: (800) 788-2949.


Our Promise: Our Pharmacy Team is committed to providing consistent, compassionate, local support.

Opioid Update 2018

CenCal Health Pharmay Update

2018 Opioid Morphine Equivalent Dose (MED) Limit

CenCal Health and its Pharmacy Benefits Manager (MedImpact), are working together to communicate formulary changes to plan providers. With the approval of CenCal Health's Pharmacy & Therapeutics Committee and in coordination with MedImpact, CenCal Health has begun a Multiphase Implementation Plan to deter over-utilization of opioids, and update utilization management measures. 

Effective 7/1/2018, CenCal Health will be implementing the following MED (Morphine Equivalent Dose) edits to help minimize the over utilization of opioids: 

  • MED (Morphine Equivalent Dose) >120mg

  Soft-Edit at the pharmacy, can be overriden by the pharmacy

  • MED (Morphine Equivalent Dose) >200mg
Hard-Stop at the Pharmacy, Prior Authorization would need to be submitted to justify the MED>200mg

In an effort to minimize disruption to members on Chronic Opioid Therapy, we are notifying providers of the MED limits that will be effective 7/1/2018. For providers with members over the future MED limit, please see the recommended actions below to ensure that there is no disruption in therapy. 

Actions to Take: 
  1. Assess patient and review diagnosis, treatment plan, and possible titration from medications and or willingness to obtain addiction treatment from the County Drug and Alcohol Services Program. 
  • Santa Barbara County: 1-888-868-1649
  • San Luis Obispo County: 1-800-838-1381

    2. If member's medical condition necessitates continuation of therapy above the 200mg MED, the following information must be submitted to obtain Prior Authorization, starting 7/1/2018: 

  • Diagnosis with medical justification 
  • Pain Assessment
  • Urine Screening-Shows concordance with prescriptions
  • Attempts made to titrate therapy
  • Alternative treatment/therapies attempted

Please contact CenCal Health Pharmacy Services Department at (805) 562-1080 if you have any questions. 



ADHD Formulary Update

CenCal Health's Formulary CNS Stimulant (ADHD medication) Quantity Limits 

Effective 4/1/2018


Brand Name

Generic Name

Quantity limit

Adderall IR 5mg, 7.5mg, 10mg, 12.5mg, 15mg, and 20mg

Amphetamine Mixed Salts Tablet

3 units per day

Adderall IR  30mg

Amphetamine Mixed Salts Tablet

2 units per day

Adderall XR 5mg, 10mg, and 15mg

Amphetamine Mixed Salts Tablet

1 unit per day

Adderall XR 20mg, 25mg, and 30mg

Amphetamine Mixed Salts Tablet

2 units per day

Concerta 18mg and 27mg

Methylphenidate ER Tablet

1 unit per day

Concerta  36mg and 54mg

Methylphenidate ER Tablet

2 units per day

Dexedrine 5mg

Dextroamphetamine Tablet

2 units per day

Dexedrine 10mg

Dextroamphetamine Tablet

4 units per day

Dexedrine SR 5mg and 15mg

Dextroamphetamine ER Capsule

2 units per day

Dexedrine SR 10mg

Dextroamphetamine ER Capsule

4 units per day

Metadate CD 10mg, 20mg, 30mg, 40mg, 50mg, and 60mg

Methylphenidate ER Capsule

1 unit per day

Ritalin IR 5mg, 10mg, and 20mg

Methylphenidate Tablet

3 units per day

Ritalin LA 10mg, 20mg, and 40mg

Methylphenidate ER Capsule

1 unit per day

Ritalin LA 30mg Capsule

Methylphenidate ER Capsule

2 units per day

Ritalin SR 10mg and 20mg

Methylphenidate ER Tablet

3 units per day

Vyvanse 10mg, 20mg, 30mg, 40mg, 50mg, 60mg, and 70mg

Lisdexamfetamine Dimesylate Capsule

1 unit per day


  • Brand Names are for reference purposes only and does not denote coverage. All brand name medications are non-formulary when the FDA approves an equivalent generic
  • The medications listed above may have additional restrictions in the form of age limits and step therapy requirements
  • For a complete list of formulary medications including restriction details, please see the CenCal Health formulary
  • Please contact CenCal Health Pharmacy Services Department at (805) 562-1080 if you have any questions or need any assistance




Formulary Updates

Formuary Updates May-June 2018

Formulary Updates March-April 2018

Formulary Updates February-March 2018

Formulary Updates January 2018



DUR: Educational Articles

The purpose of this edicational intervention component of DUR is to improve the quality and cost-effectiveness of prescribing and dispensing practices for Medi-Cal recipients. Eduational interventions include ongoing dissemination of information through the Medi-Cal provider bulleting process about clinically important, drug-specific therapy problems. 

In the Pharmacy: Pharmacists Furnishing Nicotine Replacement Products

Drug Safety Communication: New Age Limit for Opioid Cough and Cold Medicines-February 2018

2017 Immunization Updates: Influenza, HepA, Meningococcal, HPV, Adult Vaccines-September 2017

Clinical Review: Drug-Induces QT Interval Prolongation-August 2017